Liver, GB, pancreas Flashcards
how can the liver respond to injury?
1) degradation of hepatocytes
2) Necrosis
3) Inflammation
4) regeneration
5) Fibrosis
An excess of ______ causes Jaundice. what blood concentration must be reached for diagnosis?
Excess bilirubin
> 2.0 mg/dl
what is the etiology of jaundice?
overproduction of blilrubin, reduced hepatocyte uptake, & obstruction of bile flow
____________ are the number 1 cause of jaundice
Hemolytic anemias
what is the difference between unconjugated, and conjugated, bilirubin?
Unconjugated-virtually insoluble, toxic
Conjugated-soluble, nontoxic
what is icterus?
yellowing of the sclera
what is the definition of hepatitis?
hepatocyte injury that is associated with inflammation
what are the etiologies of hepatitis?
hepatotrophic viruses
autoimmune
drug
toxic agents
Hepatitis ________ infections are characterized as: Benign, self-limited infection, no chronic or carrier state
Hepatitis A
How is Hepatitis A transmitted? what is the incubation time? What type of virus is it?
- RNA virus
- Fecal or oral transmission
- Incubation 2-6 weeks
Hepatitis B is caused by what type of virus? how is it spread? what is the incubation time?
DNA virus
Parenteral / sexual spread
Incubation 30-180 days
what are the 3 types of Hepatitis B infections?
Carrier, chronic, cirrhosis
what type of cancer can be caused by hepatitis B?
Hepatocellular carcinoma
T/F: most infections of Hepatitis B lead to cirrhosis or chronic hepatitis
FALSE
95% are self-limiting
what are the “hallmark” features of Hepatitis C?
Persistent infection + chronic hepatits
found in 85% of cases
what virus type is Hepatitis C? whats its incubation time?
- RNA virus
- majority of infections progress
- Incubation 7-8 weeks, acute phase asymptomatic
why is there no available vaccine for hepatitis C?
Hepatitis C has a lot of genomic instability
keeps mutating
what are the histological characteristics of an ACUTE viral hepatitis infection?
Panlobular disarray, Inflammation, Hepatocyte necrosis
condition resolves in 8 weeks
which hepatitis strains are most likely to cause a “Fulminant “?
(Fulminant = mass liver necrosis, results in acute liver failure)
** Hepatitis C
- Hep B can also cause it
what is the definition of chronic hepatitis?
Abnormal liver function for >6 weeks
Hepatitis B induced liver disease is an important precursor for _________
HCC
hepatocellular carcinoma
what determines the ultimate outcome for Hepatitis B?
Host immune response
Hepatocyte damage likely reflects CD8+ cytotoxic T cell damage to Hepatitis B infected hepatocytes
an infection with Hepatitis ____ does not increase liver enzymes such as serum aminotransferases
Hepatitis G
the pathology of autoimmune hepatitis is associated with what?
T-cell mediated autoimmunity
Alcoholic liver disease is caused by the overlapping of what 3 conditions?
1) hepatic steatosis (fatty liver)
2) EtOH hepatitis
3) cirrhosis (fibrosis + nodules)
what condition is associated with “Mallory” bodies in the liver?
fatty liver (from alcoholism)
AND
alpha-1 trypsin defeciencies
what are mallory bodies?
- clumps of cytokeratins
- eosinophilic
______________ is the most common non-alcohol fatty liver disease
Metabolic liver disease
in cases of cirrhosis, there will be histological evidence of bridging ______
septae
what are the symptoms of Portal hypertension from cirrhosis?
Ascites
Collateral venous channels
Splenomegaly
what causes hemochromatosis ?
1) excess Iron: accumulation in liver, pancreas, heart
2) genetic
what is the most common type of genetic hemochromatosis?
most common is Homo-zygous recessive
- mutation on Chromosome 6
what is the morphology of hemochromatosis?
Hemosiderin
Fibrosis
name the “classic triad” associated with hemochromatosis
1) micronodular cirrhosis
2) diabetes mellitus
3) skin pigmentation
what causes Wilson’s disease? what organs does it effect?
A) Autosomal RECESSIVE disease
B) results from a failure to incorporate copper (Cu) into ceruloplasmin
C) Copper accumulates in liver, brain, eyes
what is the clinical presentation for Wilson’s disease?
- acute or chronic liver disease. May present with tremor or behavioral changes
- presents between 6 to 40 years of age